Abstract 227: Single-blind Study of Q-sweat in Postural Orthostatic Tachycardia Syndrome (POTS)

2016 ◽  
Vol 119 (suppl_1) ◽  
Author(s):  
Muhammad M Ahsan ◽  
Tara Thompson ◽  
Chandralekha Ashangari ◽  
Amer Suleman
Keyword(s):  
Orthostatic Intolerance ◽  
Electrical Current ◽  
The Body ◽  
Blind Study ◽  
Sweat Glands ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Onset Latency ◽  
Excessive Sweating ◽  
Sweat Production ◽  
Single Blind

Background: Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia that is estimated to impact between 1,000,000 and 3,000,000 Americans and millions more around the world. Symptoms often include orthostatic intolerance such as dizziness, fatigue, excessive sweating and many others. The aim of this study is to determine the Q-sweat study in POTS patients. Methods: This study was a randomized, single-blind study. Patients evaluated between October 2014 to June 2015 were included. The skin on the leg and wrist is wiped with acetone, then alcohol and dried, cleaning the skin in preparation for the test. Four electrodes filled with acetylcholine are placed on three areas of the leg and one area on the wrist. A mild electrical current called iontophoresis is then applied to help the drug stimulate the sweat glands. This evokes sweating at the site, but it also allows the body to release its own acetylcholine, resulting in sweat production at nearby sites. After a stimulus (e.g. a deep breath) any deviation from the baseline is reported. If no change is seen, a stronger stimulus is applied (e.g. electrical stimulation) and if there is still no change seen, an “absent response” is reported. The onset latency and magnitude of response can be quantified, although the results are highly variable within and between subjects. The sweat response is measured Q-sweat recordings of Left proximal leg, Left distal leg and Left foot sites were analyzed. Results are categorized as Normal response, no response, hung up and prolong response. Results: A total 144 POTS patients were included, Out of 144 POTS patients 88% are females (n=127, mean age 31.93±12.37) and 12% are males (n=17, mean age 31.59±11.14), Left proximal leg site 69/144(48%) Patients had hung up, 8/144(6%) had No response, 29/144(20%) had Normal, 38/144(26%) had Prolong. Left distal leg site 72/144(50%) had hung up, 13/144(9%) had No response, 23/144(16%) had Normal, 36/144(25%) had Prolong. Left foot site 36/144(25%) had hung up, 35/144(24%) had No response, 40/144(28%) had Normal, 33/144(23%) had Prolong response. Conclusion: Postural Orthostatic Tachycardia Syndrome had a higher percentage of patients with Hung up response.

Abstract 46: Study of Symptoms Variation in the Morning and Evening in Postural Orthostatic Tachycardia Syndrome (POTS)

2016 ◽  
Vol 119 (suppl_1) ◽  
Author(s):  
Muhammad M Ahsan ◽  
Tara Thompson ◽  
Chandralekha Ashangari ◽  
Amer Suleman
Keyword(s):  
Chest Pain ◽  
Orthostatic Intolerance ◽  
Early Morning ◽  
P Value ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Shortness Of Breath ◽  
Blurred Vision ◽  
Excessive Sweating ◽  
Study Results ◽  
Daily Function

Background: Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia that is estimated to impact between 1,000,000 and 3,000,000 Americans and millions more around the world. Patients chronically have symptoms that are worse with upright posture and that improve with recumbence. Symptoms often include orthostatic intolerance such as dizziness, fatigue, excessive sweating and many others. The aim of this study is to determine the variation of symptoms early morning after wake up and evening at 4 PM. Methods: The Autonomic nervous system questionnaire consisting of eight POTS symptoms palpitations, headaches, dizziness, shortness of breath(SOB), chest pain, weakness, blurred vision and heaviness of feet was handover to the patients at our clinic. 42 POTS patients participated in the study, participated patients had been asked to scale their symptoms early morning after wake up and evening at 4 PM. Symptoms were defined 0 as Never,1 as mild,2 as moderate,3 as severe ,4 as extreme and 5 impairing daily function and living. Results: Out of 42 POTS patients 90% are female (38/42, age 31.74±10.67) and 10% are males (4/42, age 30.75±13.20), symptoms were scaled early morning after wake up vs symptoms scaled evening at 4 pm results in mean±SD and Anova P value. Palpitations 1.69±1.32 vs 2.45±1.38 (P =0.01), Dizziness 2.40±1.38 vs 2.67±1.46 (P =0.40), Chest pain 0.93±1.02 vs 1.52±1.27 (P=0.02), SOB 1.36±1.32 vs 1.81±1.40 (P=0.13), Weakness 2.79±1.37 vs 3.12±1.38 (P=0.27), Blurred vision 1.38±1.29 vs 1.48±1.27 (P=0.73), Headaches 1.74±1.36 vs 2.52±1.38 (P =0.01), Heaviness of feet 0.95±1.19 vs 1.43±1.53 (P =0.11). Conclusion: Our study results demonstrated that the patients with POTS had significant variation in symptoms Palpitations, Chest pain, Headaches in evenings when compared to early morning after wake up.

scholarly journals The Design and Development of Active Compression Garments for Orthostatic Intolerance

2017 ◽  
Author(s):  
Julia Duvall ◽  
Rachael Granberry ◽  
Lucy E. Dunne ◽  
Brad Holschuh ◽  
Christopher Johnson ◽  
...  
Keyword(s):  
Venous Return ◽  
Orthostatic Intolerance ◽  
Dynamic Control ◽  
The Body ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Compression Stockings ◽  
Design And Development ◽  
Compression Garments ◽  
Prototype Development ◽  
Low Profile

Current compression garments are often made from a spandex-type elastic material with static levels of compression and can become uncomfortable and difficult to don/doff [1]. This limits their usability, especially for unhealthy or aging populations. The only current alternative to elastic compression stockings are inflatable compression sleeves that are controllable, but highly immobile and must be tethered to an inflation source [2]. Neither design offers a solution that is simultaneously low profile, mobile, and controllable. Here we present the design and development of compression garments with embedded shape-changing materials that can produce controllable compression without the need for a bulky inflation system. This active materials approach enables dynamic control over the degree, timing and location of compression, and allows for graded, synchronized, pulsed, and peristaltic compression patterns, which provide the medical benefit of moving fluid in the body [2]. Such a design combines the best features of both elastic and inflatable compression garments: a slim, low-profile form factor that is easy to don/doff and provides dynamic control. Shape memory alloy (SMA) coil actuators, as described by Holschuh et al., [3] have the ability to apply compressive forces to the body when paired with passive textiles and wrapped circumferentially around the body. These actuators are engineered to contract when heated, creating controllable forces and displacements that are modulated through an applied current. SMA compression garments (SMA-CG) have important applications, from consumer uses to clinical interventions, including: augmenting venous return for conditions of orthostatic intolerance (e.g., postural orthostatic tachycardia syndrome (POTS)); cardiac rehabilitation in heart failure patients; lymphedema venous insufficiency; reducing deep vein thrombosis (DVT) risk; sports performance; and countermeasures for flight or space flight. While the potential uses for this technology are broad, the basic design is similar across many conditions. Key research areas include: 1) identifying and addressing design considerations relevant to prototype development of SMA-CG; 2) determining the compression thresholds needed to dynamically oppose orthostatic changes; and 3) evaluating the effectiveness of the prototypes for augmented venous return by synchronizing compression during cardiac diastole. Here, we focus on the first question: design of SMA-CG prototypes.

A Comparison between the Efficacy of Ketotifen and Clemastine in Children

1980 ◽  
Vol 8 (6) ◽  
pp. 408-412 ◽  
Author(s):  
Z Hloušková ◽  
M Gutová ◽  
Z Hloušek
Keyword(s):  
Body Weight ◽  
Bronchial Asthma ◽  
Total Duration ◽  
The Body ◽  
Blind Study ◽  
Clinical Parameters ◽  
Single Blind ◽  
Significant Superiority ◽  
Marked Benefit

In a controlled single-blind study of 12 weeks' duration the prophylactic antiasthmatic effects of ketotifen and clemastine in children with bronchial asthma were compared. The drugs were administered in syrup form in doses from 1 to 2 mg per day according to the body-weight. Fifty-seven children, twenty-nine in the ketotifen group and twenty-eight in the clemastine group took part. The clinical parameters, namely asthmatic complaints, dyspnoea and total duration of asthmatic attacks initially improved with both drugs but only with ketotifen was there a further marked benefit leading to a significant superiority of this drug over clemastine in the 8th and 12th week of treatment. In the overall assessment ketotifen was considered to be very effective and effective in 83% of the patients, clemastine was considered to be very effective and effective in 29%. Both drugs were well tolerated.

The Role of Computer Modeling in Electrocardiography

1990 ◽  
Vol 29 (04) ◽  
pp. 282-288 ◽  
Author(s):  
A. van Oosterom
Keyword(s):  
Electrical Activity ◽  
Computer Modeling ◽  
Body Surface ◽  
Electrical Current ◽  
The Body ◽  
Volume Conductor ◽  
Current Generator ◽  
Cardiac Electrical Activity ◽  
Source Models

AbstractThis paper introduces some levels at which the computer has been incorporated in the research into the basis of electrocardiography. The emphasis lies on the modeling of the heart as an electrical current generator and of the properties of the body as a volume conductor, both playing a major role in the shaping of the electrocardiographic waveforms recorded at the body surface. It is claimed that the Forward-Problem of electrocardiography is no longer a problem. Several source models of cardiac electrical activity are considered, one of which can be directly interpreted in terms of the underlying electrophysiology (the depolarization sequence of the ventricles). The importance of using tailored rather than textbook geometry in inverse procedures is stressed.

Influence of Vitamin E on Plasma Malondialdehyde- Like Material in Man

1984 ◽  
Vol 51 (03) ◽  
pp. 347-348 ◽  
Author(s):  
C Cordova ◽  
A Musca ◽  
F Violi ◽  
C Alessandri ◽  
A Ghiselli ◽  
...  
Keyword(s):  
Vitamin E ◽  
Healthy Subjects ◽  
Placebo Treatment ◽  
Blind Study ◽  
Single Blind ◽  
Plasma Malondialdehyde

SummaryThe behaviour of plasma malondialdehyde-like material (MDA-LM) was evaluated in 13 healthy subjects by a single-blind study that consisted of placebo (30 days), vitamin E treatment (300 mg/day) (30 days) and placebo (30 days). The study demonstrated that MDA-LM did not change during placebo treatment while it significantly decreased after vitamin E administration.

scholarly journals Experiments on Energy-Efficient Evaporative Cooling Systems for Poultry Farm Application in Multan (Pakistan)

2021 ◽  
Vol 13 (5) ◽  
pp. 2836
Author(s):  
Khawar Shahzad ◽  
Muhammad Sultan ◽  
Muhammad Bilal ◽  
Hadeed Ashraf ◽  
Muhammad Farooq ◽  
...  
Keyword(s):  
Heat Stress ◽  
Low Cost ◽  
Evaporative Cooling ◽  
Thermal Exposure ◽  
Climatic Conditions ◽  
The Body ◽  
Dew Point ◽  
Sweat Glands ◽  
Cooling Systems ◽  
Humidity Index

Poultry are one of the most vulnerable species of its kind once the temperature-humidity nexus is explored. This is so because the broilers lack sweat glands as compared to humans and undergo panting process to mitigate their latent heat (moisture produced in the body) in the air. As a result, moisture production inside poultry house needs to be maintained to avoid any serious health and welfare complications. Several strategies such as compressor-based air-conditioning systems have been implemented worldwide to attenuate the heat stress in poultry, but these are not economical. Therefore, this study focuses on the development of low-cost and environmentally friendly improved evaporative cooling systems (DEC, IEC, MEC) from the viewpoint of heat stress in poultry houses. Thermodynamic analysis of these systems was carried out for the climatic conditions of Multan, Pakistan. The results appreciably controlled the environmental conditions which showed that for the months of April, May, and June, the decrease in temperature by direct evaporative cooling (DEC), indirect evaporative cooling (IEC), and Maisotsenko-Cycle evaporative cooling (MEC) systems is 7–10 °C, 5–6.5 °C, and 9.5–12 °C, respectively. In case of July, August, and September, the decrease in temperature by DEC, IEC, and MEC systems is 5.5–7 °C, 3.5–4.5 °C, and 7–7.5 °C, respectively. In addition, drop in temperature-humidity index (THI) values by DEC, IEC, and MEC is 3.5–9 °C, 3–7 °C, and 5.5–10 °C, respectively for all months. Optimum temperature and relative humidity conditions are determined for poultry birds and thereby, systems’ performance is thermodynamically evaluated for poultry farms from the viewpoint of THI, temperature-humidity-velocity index (THVI), and thermal exposure time (ET). From the analysis, it is concluded that MEC system performed relatively better than others due to its ability of dew-point cooling and achieved THI threshold limit with reasonable temperature and humidity indexes.

scholarly journals Circulating levels of growth hormone in postural orthostatic tachycardia syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Madeleine Johansson ◽  
Fabrizio Ricci ◽  
Janin Schulte ◽  
Margaretha Persson ◽  
Olle Melander ◽  
...  
Keyword(s):  
Heart Rate ◽  
Growth Hormone ◽  
Orthostatic Intolerance ◽  
High Sensitivity ◽  
Symptom Assessment ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Daily Life Activities ◽  
Median Plasma ◽  
Symptom Assessment Scale ◽  
Plasma Gh

AbstractPostural orthostatic tachycardia syndrome (POTS) is a cardiovascular autonomic disorder with poorly understood etiology and underlying pathophysiology. Since cardiovascular morbidity has been linked to growth hormone (GH), we studied GH levels in patients with POTS. We conducted an age-sex-matched case–control study in patients with POTS (age 31 ± 9 years; n = 42) and healthy controls (32 ± 9 years; n = 46). Plasma GH levels were measured using high-sensitivity chemiluminescence sandwich immunoassay. The burden of orthostatic intolerance symptoms was assessed by the Orthostatic Hypotension Questionnaire (OHQ), consisting of a symptom assessment scale (OHSA) and a daily activity scale (OHDAS). POTS patients had significantly higher composite OHQ score than controls, more symptoms and less activity. Supine heart rate and diastolic blood pressure (BP), but not systolic BP, were significantly higher in POTS. Median plasma GH levels were significantly lower in POTS (0.53 ng/mL) than controls (2.33 ng/mL, p = 0.04). GH levels were inversely related to OHDAS in POTS and supine systolic BP in POTS and controls, but not heart rate neither group. POTS is associated with lower GH levels. Impairment of daily life activities is inversely related with GH in POTS. A higher supine diastolic BP is inversely associated with GH levels in POTS and healthy individuals.

scholarly journals Anesthetic Efficacy of a Combination of 0.5 M Mannitol Plus 127.2 mg of Lidocaine With 50 μg Epinephrine in Inferior Alveolar Nerve Blocks: A Prospective Randomized, Single-Blind Study

2013 ◽  
Vol 60 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Steven Smith ◽  
Al Reader ◽  
Melissa Drum ◽  
John Nusstein ◽  
Mike Beck
Keyword(s):  
Postoperative Pain ◽  
Inferior Alveolar Nerve ◽  
Blind Study ◽  
Maximum Output ◽  
Nerve Blocks ◽  
Posterior Teeth ◽  
Solution Deposition ◽  
The Times ◽  
Pulpal Anesthesia ◽  
Single Blind

Abstract The purpose of this prospective, randomized, single-blind study was to determine the anesthetic efficacy of 127.2 mg lidocaine with 50 μg epinephrine compared to 127.2 mg lidocaine with 50 μg epinephrine plus 0.5 M mannitol in inferior alveolar nerve (IAN) blocks. Forty subjects randomly received 2 IAN blocks consisting of a 3.18 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine and a 5 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine (3.18 mL) plus 0.5 M mannitol (1.82 mL) in 2 separate appointments spaced at least 1 week apart. Mandibular anterior and posterior teeth were blindly electric pulp tested at 4-minute cycles for 60 minutes postinjection. Pain of solution deposition and postoperative pain were also measured. No response from the subject to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Total percent pulpal anesthesia was defined as the total of all the times of pulpal anesthesia (80 readings) over the 60 minutes. One hundred percent of the subjects had profound lip numbness with both inferior alveolar nerve blocks. The results demonstrated that a 5 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine plus 0.5 M mannitol was significantly better than the 3.18 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine for all teeth. Solution deposition pain and postoperative pain were not statistically different between the lidocaine/mannitol formulation and the lidocaine formulation without mannitol. We concluded that adding 0.5 M mannitol to a lidocaine with epinephrine formulation was significantly more effective in achieving a greater percentage of total pulpal anesthesia than a lidocaine formulation without mannitol.

Abstract 222: Nerve Conduction Study in Postural Orthostatic Tachycardia Syndrome

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Chandralekha Ashangari ◽  
Samreen F Asghar ◽  
Sadaf Syed ◽  
Amna A Butt ◽  
Amer Suleman
Keyword(s):  
Heart Rate ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Clinical Symptoms ◽  
Orthostatic Intolerance ◽  
Tibial Nerve ◽  
Sensory Nerves ◽  
Exercise Intolerance ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Medical Diagnostic

Background: Postural orthostatic tachycardia syndrome (POTS) is an autonomic disturbance characterized by the clinical symptoms of orthostatic intolerance, mainly light headedness, fatigue, sweating, tremor, anxiety, palpitation, exercise intolerance and near syncope on upright posture. These are relieved on lying down. Patients also have a heart rate >120 beats/min (bpm) on standing or increase their heart rate by 30 bpm from a resting heart rate after standing for 10 min. A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. The aim of this study is to demonstrate median, ulnar, peroneal, tibial nerve conduction results POTS patients. Methods: 177 patients were selected randomly from our clinic with POTS. Nerve conduction results of median, ulnar, peroneal, tibial nerves were reviewed from electronic medical records. Results: Out of 177 patients, 151 patients are females (85%, n=151, age 32.07±11.10), 26 patients are males (15%, n=26, age 29.08±17.40).Median nerve conduction results are 57.83 m/sec ±7.58 m/sec, Ulnar nerve conduction results are 56.62 m/sec ±6.85 m/sec, Peroneal nerve conduction results are 49.96 m/sec ±6.85 m/sec, Tibial nerve conduction results are 50.70 m/sec ±6.86 m/sec. Conclusion: The nerve conduction velocities tend to be within normal range in Postural Orthostatic Tachycardia Syndrome (POTS) patients.

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